HomeMy WebLinkAbout12319 MACLURE DReAK ENCROACHMENT PERMIT
CITY OF BAKERSFIELD
d PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
+Mry BAKERSFIELD CA 93301
O LIFO (661) 326-3724
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA:
Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place,
erect, use and maintain an encroachment on public property or right of way as therein defined.
Application Nuober . . . . . 12-30000039 Date 10/12/12
Property Address 12319 MACLURE DR
Application type description PW - ENCROACENR NT PERMIT
Owner Contractor
HASKINS MATTHEW T 6 RACHELLE B OWNER
12319 MACLURE DR
BAKERSFIELD CA 93311
---------------------------- ___________________________________
Perri[ . . . ENCROACHMENT PERMIT
Additional deep . .
Phone Access Cade . 1253996
Perrit Fee . . . . 208.00
Issue Date . . . . 10/12/12 Valuation
Qty Unit Charge Per Extension
BASE F&E 209.00
Special Notes and Comments
Place fence behind sidewalk on the aide
of house. Fence to be 6- from highest
point.
Contact:
Matthew Hoskins 661-205-8758
____________________________________________________________________________
Fee summary Charged Paid Credited Due
Permit Fee Total 200.00 208.00 .00 .00
Grand Total 208.00 208.00 .00 .00
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to
revoke the crit at any time. J
5
Sign ure of Applicant Owner/Agent) Print Name
I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING
APPLICATION AND FIND THAT THE MAINTENANCE OF SAID ENCROACHMENT (1) WILL (NOT)
SUBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2)
WILL (NO UTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE (GRANT DENIED) Said permit shall expire on date stated above.
Signature of City Engin e
Additional Terms on the Back
ENCROACHMENT PERMIT 37
APPLICATION FORM
v co CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
.;e A 1501 TRUXTUN AVE
gLjFO \ BAKERSFIELD CA 93304
(661)326-3724 Fax: (661) 852-2012
LOCATION OFENCROACHMENT(Address required where available):
1--;l3/G W7,,a,- Dr em 1?331
If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
APPLICANT INFORMATION
FULL NAME OF APPLICANT I/P,,Tfltt. I -//AS K:y5
COMPLETE ADDRESS: PHONE: Cr6/
%�5'/% LNlaa(✓: t /�� FAX:
;balms/s-frG (o'( lm %.311 CELE:
PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
PERIOD OF TIME FOR ENCROACHMENT: EFINATE r OTHEk:
CONTACTPERSON Mo.7'{"litew PHOI:—
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City,ita
officers agents and employees againstany and all liability, claims, actions, causes of action or demands, whatsoever
against them, or any of them, before administrative, quasi-judicial, orjudicial tribunals of any kind whatsoever, arising out
of, connected with, or caused by applicant's placement, erection, use (by applicant or any other person or entity) or
maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of
said encroachment or until such time that this permit is. revoked.
Applicant further agrees that uponthe expiration of the permit for which this application is made, if granted or
revocation thereof by the City Engineer, applicant will at his own cot and expense remove the same from the
property or right of wax where the same is located, and restore said publicproperty or right of way to the cond.
nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment.
Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for
however long the encroachment remains.. Applicant shall furnish the City Risk Manager with a Certificate. of Insurance
evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidencing
the insurance required.. The type(s) and amount(s) of insurance coverage required are:
Residences: Homeowners General Liability coverage in an amount of at least $300.000.00
Commercial: Commercial Liability coverage in an amount of at least $1,000,000.00
Encroachment Permit Fee: $208.00
SAPERMITSTNCROACIEEncroachment Permit Req Form.DOC January, 2009
Public Works Department
1501 Truxtun Avenue
Bakersfield, California. 93301
(661) 326-3724
APPLICATION FOR ENCROACHMENT PERMIT
Permit Fee $208.00
To the City Engineer of the City of Bakersfield, California:
Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to
place, erect, use and maintain an encroachmentonpublic property or right-of-way astherein defines.
1. Full nameof applicant and complete address including phone number: N\ .AA W r��r t�liS
ll ict, -D' i X33 t t
2. Nature or description of the. encroachment for which this application is mat, (Example: Wood or wrought iron
fence, concrete block wall, raised planter, etc...) T Weld lrk-c. ,�^u�2 m� w00G t-e.nct
f('m 1a ,re 't 5 'Ft) 'rirt �`Ctxa ally
3. Location of proposed encroachment: (Example: Side yard at back ofsldewalk or front yard at back of sidewalk)
6-e..x% -6 '6ce2.wa1v— - -_
4. Period of time for which the encroachment is to be maintainedrIndefmlte or Other.
5. Is property part of a Homeowner's Association -YesNp
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, its
officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever
against them, or any of them, before administrative, quasi-judicial, orjudidial tribunals of any kind whatsoever, arising out
of, connected with, or caused by applicants placement, erection, use (by applicant or any other person or entity) or
maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life
of said encroachment or until such time that this permit is revoked.
Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or upon
revocation thereof by the City engineer, applicant will at his own cost and expense remove the same from the cubiti
property or right of way where the same is located, and restored said public property or right of way to the condition as
nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment.
Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for
however long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of Insurance
evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidenc-
ing the insurance required. The type(s) and amounts) of insurance coverage is:
Applicant acknowledges theright of the City Engineer, pursuant to. Bakersfield Municipal Code Chapter 12.20 to revoke the permit at
any tmc.
696ncroaUmentPeimitsApplicationforencroachment
B .A K E R S E I E L C,
Public Works Departmeni
1501 Trurtun Avenue
Bakersfield, California 93391
(651) 326-3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fencebeside the sidewalk within me
Public right-of-way.
�2jMU'F L.n By: /✓Iu-likzw �.`"'�6u/e �StG1nS
iSvicet for praposetl enerecchr:entj S�'ners Nam_1
of /�3 YV acL Ac �r 2kit� ci-') 9?Yl Phanr Cool -G(a 3-1/1/3 Z
(Address of praposed mcroach=n[)
SIGNED:
1.) Name:
*11PKV/\JY.1jAJ
Aaaress:
2.) Name
Ad—esi J
!
3Name:
.)
'�` nfvk
CC3CL
Address:
17UhlF MMV(f._
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4.) Name:
Address.
5.) Name:
AOare55:
/'�q /a-2
Date: /0-'r -tZ.
Dale: -11-
Date: (V' I),IZ
Date:
5.) Name: Date:
Aacress
!NS,U.RE 01 ND.~;G NT IS' FC)RN1 A'i!Ord
(Named Insured)
Name. and Mailing Address
MATTHEW HASKINS
12319 MACLURE DR
BAKERSFIELD CA 93311
The Residence premises is located at
12319 MACLURE DR
BAKERSFIELD CA 93311
homeowners Policv No.
983257612 633 1
Your Insurer
Travelers Commercial Insurance Company
One of The Travelers Property Casualty Companies
One Tower Square, Hartford, CT 06183
TOTAL POLICY PREMIUM
This is not a bili; you will be invoiced separately.
TRAVELERSJ
QAi'� (ni.l.ii, I{7111 7':it: t..:it?.-1 T lfi�a
Agent Information
CENTEX INSURANCE AGENCY
8407 FALLBROOK AVE STE 200
WEST.HILL, CA 91304
Mortgagee Name and Address.
1. BANK OF AMERICA, NA
ISAOA ATIMA.
PO BOX 961206
FORT WORTH TX 76161
LOAN NUMBER 209039973
Policy. Period
06/26/12- 06/26/13 12:01 A.M.
Standard Time at the residence premises
For Claim Service Call
For Policy Service Call
1-800-CLAIM33
1-800-842-5075
$., 948;00
Continued on next page
670lOM2244 PL -12830 &06 Insuretl Copy Page t of 4
OCE91410093S F3115CK 7615 05/07/12
r ,. _u _ , Ai.-
LIMIT
Section I - Property. Coverages
A- DWELLING ............................................. _ .................. $. 268.000
B - OTHER STRUCTURES........................................................ $ 26.800
C - PERSONAL PROPERTY........................................................ $ 187,600
D - LOSS OF USE.............................................................. $ 134.000
LIMITED FUNGI, OTHER MICROBES OR ROT REMEDIATION
Section I - Property Coverage .......................................... _ ..... $ 5,000
Section II - Liability Coverages
E - Personal Liability (Bodily Injury and Property Damage) Each Occurrence.. 8 300.000
F -Medical Payments. to Others Each Person.. .... .................. ........ $ 5,000
Your Savings
The following credits or discounts reduced your premium: Loss Free Discount,
Protective Devices Discount
Deductibles
DEDUCTIBLE
Section I
Property Coverages
Deductible (All Other Perils) .................
$ 1,000
Section I
.Limited Earthquake
Deductible Percentage
15%
In case of loss under section I, only that part of the loss over the stated
deductible is covered.
'kPTIUN>AL &iii DORSMERA EtNTS ANO C01VIr^RSiGES LIMIT PREMIUM
Optional Endorsements
HO -55 CA (05-07) Limited Earthquake Coverage ............................ $ 268.00
Masonry Veneer Excluded
HO -85 CA (06-09) Enhanced Home Package .................................. Included"
Water Back Up And Sump Discharge Or...... $5,000
Overflow
Additional Replacement Cost Protection... 50%
438BFU NS (05-42) Lender's Loss Payable Endorsement ....................... Included"
h',,AN,u'::i;-0F-( F:r IlISAi`arwl
HO -3 (10-06) Homeowners 3. Special Form
Continued on next page
67010=44 PL -12630 6.06 Insured Copy Page 2 of(l
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B A h E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager 40
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: October 12, 2012
SUBJECT: Encroachment Permit Application for: 12319 Maclure Dr
Name of Applicant: Matthew T Haskins
Description of Encroachment Place fence behind sidewalk on the side of
house not to exceed 6' from the highest
point.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
Madure Dr. doe
B A k E R S F S E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer II
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: October 12, 2012
SUBJECT: Encroachment Permit Application for: 12319 Maclure Dr
Name of Applicant: Matthew T Haskins
Description of Encroachment: Place fence behind sidewalk on the side of
house not to exceed 6' from the highest
point.
Please review the attached encroachment permit and return to me at your earliest convenience.
10/22/20/2
WF
5:\PERMITSIENCROACH\TRAFFIC\12319 Madure Dr.Goc